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Victorian Rural Ambulance Services: Fulfilling a Vital Community Need

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Victorian Rural Ambulance Services: Fulfilling a Vital Community Need PUBLIC ACCOUNTS AND ESTIMATES COMMITTEE FIFTY EIGHTH REPORT TO THE PARLIAMENT Report on the Review of the Auditor-General’s special report no. 51 - Victorian Rural Ambulance Services: fulfilling a vital community need NOVEMBER 2004 Ordered to be printed By Authority Government Printer for the State of Victoria No. 96 Session 2003-2004 CONTENTS PUBLIC ACCOUNTS AND ESTIMATES COMMITTEE MEMBERSHIP – 55TH PARLIAMENT............................................................................................................5 PUBLIC ACCOUNTS AND ESTIMATES COMMITTEE CONTACT DETAILS .........6 DUTIES OF THE COMMITTEE .................................................................................7 CHAIR’S INTRODUCTION ........................................................................................9 EXECUTIVE SUMMARY .........................................................................................11 RECOMMENDATIONS............................................................................................17 CHAPTER 1: BACKGROUND TO THE REVIEW ................................................21 1.1 Introduction..................................................................................................21 1.2 Background to special report no. 51 - Victorian Rural Ambulance Services: fulfilling a vital community need ...................................................................21 1.3 Findings of the Auditor-General...................................................................22 1.4 Response to the Auditor-General’s report by the Secretary of the Department of Human Services...................................................................22 1.5 Follow-up by the Auditor-General ................................................................22 1.6 Scope of the review undertaken by the Committee .....................................23 CHAPTER 2: OVERVIEW OF OPERATIONS......................................................25 2.1 Overview of operations of the Victorian Rural Ambulance Service..............25 CHAPTER 3: FINANCIAL MANAGEMENT..........................................................27 3.1 Development of a funding model .................................................................27 3.2 Operational results ......................................................................................33 CHAPTER 4: OVERTIME AND INDUSTRIAL RELATIONS ................................37 4.1 Review by the Auditor-General....................................................................37 4.2 Response by the Minister for Health............................................................38 4.3 Current situation with overtime ....................................................................39 4.4 Reasons for high levels of overtime.............................................................40 4.4.1 Training........................................................................................... 41 4.4.2 Sick leave ....................................................................................... 41 4.4.3 Occupational health and safety....................................................... 42 i Report on the Review of Victorian Rural Ambulance Services 4.4.4 Multiple officer responses and overtime.......................................... 43 4.4.5 Stand-by and rostered on-call provisions........................................ 44 4.4.6 Rostering ........................................................................................ 45 4.5 Industrial relations environment...................................................................46 4.6 Summary .....................................................................................................47 CHAPTER 5: COMMUNICATIONS ......................................................................51 5.1 The call-taking and dispatch process ..........................................................51 5.2 Infrastructure supporting the call-taking and dispatch process....................52 5.3 Actions taken by the Government to address communication deficiencies .54 (a) Mobile Data Network Project .................................................. 55 (b) Metropolitan Mobile Radio Project.......................................... 55 (c) Emergency Alerting System ................................................... 55 (i) Mobile radio equipment.................................................. 56 (ii) Automatic vehicle location.............................................. 57 (iii) Radio communications network ..................................... 57 (iv) Computer Aided Dispatch .............................................. 57 (v) Structured call-taking ..................................................... 58 5.4 Government response to bridging strategy..................................................59 5.5 Summary .....................................................................................................60 CHAPTER 6: PERFORMANCE MANAGEMENT AND MEASUREMENT ...........63 6.1 Need for performance measurement...........................................................63 6.2 Availability of performance information........................................................65 6.2.1 Report on Government Services..................................................... 65 6.2.2 Rural Ambulance Victoria annual report ......................................... 66 6.2.3 The Convention of Ambulance Authorities Report 2002-03 ............ 68 6.3 RAV data analysis .......................................................................................68 6.4 Summary .....................................................................................................70 CHAPTER 7: CLINICAL STANDARDS................................................................73 7.1 Need for high level clinical standards ..........................................................73 7.2 Development of clinical standards and staff training....................................74 7.3 Quality of patient care records and the recording of clinical information......75 7.4 Clinical performance measurement .............................................................75 7.5 Summary .....................................................................................................77 ii Contents CHAPTER 8: INFRASTRUCTURE PROGRAM ...................................................79 8.1 Status of Rural Ambulance Victoria infrastructure .......................................79 8.2 Capital planning...........................................................................................80 8.3 Summary .....................................................................................................81 CHAPTER 9: CORPORATE AND BUSINESS PLANNING .................................83 9.1 Planning strategies ......................................................................................83 9.2 Quality of strategic planning ........................................................................84 CHAPTER 10: SUBSCRIPTIONS ..........................................................................87 10.1 Subscription revenue...................................................................................87 10.2 Incentives to increase subscription revenue................................................88 10.3 Financial implications of the subscriber scheme..........................................90 CHAPTER 11: AMALGAMATION OF AMBULANCE SERVICES .........................91 11.1 Amalgamation of Rural Ambulance Services...............................................91 11.2 Potential for further rationalisation of ambulance services in Victoria..........91 APPENDIX 1: LIST OF PERSONS AND DEPARTMENTS PROVIDING EVIDENCE AND SUBMISSIONS...................................................95 APPENDIX 2: ACRONYMS AND ABBREVIATIONS............................................97 iii PUBLIC ACCOUNTS AND ESTIMATES COMMITTEE MEMBERSHIP – 55TH PARLIAMENT Hon. C Campbell, MP (Chair) Hon. B Forwood, MLC (Deputy Chair) Hon. B Baxter, MLC Mr R Clark, MP Mr L Donnellan, MP Ms D Green, MP Mr J Merlino, MP Hon. G Rich-Phillips, MLC Ms G Romanes, MLC This inquiry was undertaken by a Sub-Committee consisting of the following Members: Hon. C Campbell, MP (Chair) Hon. B Baxter, MLC Mr R Clark, MP Mr J Merlino, MP Ms G Romanes, MLC For this inquiry, the Committee was supported by secretariat staff comprising: Executive Officer: Ms M Cornwell Specialist Advisor: Mr T Wood Office Manager: Ms K Taylor 5 Report on the Review of Victorian Rural Ambulance Services PUBLIC ACCOUNTS AND ESTIMATES COMMITTEE CONTACT DETAILS Address: Level 8 35 Spring Street Melbourne Victoria 3000 Telephone: (03) 9651 3556 Facsimile: (03) 9651 3552 Email: [email protected] Internet: http://www.parliament.vic.gov.au/paec 6 DUTIES OF THE COMMITTEE The Public Accounts and Estimates Committee is a joint parliamentary committee constituted under the Parliamentary Committees Act 2003. The Committee comprises nine Members of Parliament drawn from both Houses of Parliament and all political parties. The Committee carries out investigations and reports to Parliament on matters associated with the financial management of the state. Its functions under the Act are to inquire into, consider and report to the Parliament on: • any proposal, matter or thing concerned with public administration or public sector finances; and • the annual estimates or receipts and payments and other Budget Papers and any supplementary estimates of receipts or payments presented
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